Healthcare Provider Details

I. General information

NPI: 1174939482
Provider Name (Legal Business Name): YUB RAJ SEDHAI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2014
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PARK ST
BOWLING GREEN KY
42101-1795
US

IV. Provider business mailing address

250 PARK ST
BOWLING GREEN KY
42101-1795
US

V. Phone/Fax

Practice location:
  • Phone: 270-780-2680
  • Fax: 270-780-2691
Mailing address:
  • Phone: 270-780-2680
  • Fax: 270-780-2691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number0101265181
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101265181
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number390200000X
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: